Médecins Sans Frontières (MSF) is urgently calling for an improved medical and humanitarian response for people fleeing the conflict in Sudan and entering South Sudan through Renk, a town located in the northernmost state of Upper Nile.

Since the fighting erupted in Sudan, around 290,000 people have entered South Sudan – 80 per cent of them through the Joda border in Upper Nile state.

Although the formal and informal transit centres in Renk are ideally a temporary stopover for people to move further into the country, returnees can spend weeks or even months there. This stay is often exhausting and painful, as people have limited access to food, shelter, water, sanitation and healthcare. 

Our teams are supporting Renk civil hospital in the measles isolation ward, as well as the inpatient therapeutic feeding centre and a paediatric ward. With the influx of patients, we have expanded the capacity of the wards from 22 to 45 beds. Since July, our teams have admitted 232 patients for malnutrition and treated 282 cases of measles requiring hospital care.

“Aid is woefully inadequate in Renk compared to the needs, which are growing every day,” says Jocelyn Yapi, MSF head of mission in South Sudan. 

“We are calling on humanitarian and medical groups to do more by strengthening activities at the entry point and at transit centres. Basic healthcare services should be made available at all times on the border for those coming with medical conditions,” says Yapi.

“A systematic vaccination catch-up should also be available 24/7 on the border, given the current low vaccination coverage in Sudan and ongoing outbreak of measles in both countries,” he says.

Limited food supply and deplorable living conditions

Many people, especially children, are arriving to the border in alarming health conditions, suffering from deadly diseases like measles or malnutrition, and require immediate medical care. Amidst the rainy season, our medical facilities in the area are recording a 70 per cent positivity rate of malaria, a disease that already kills more people than any other in South Sudan. 

“Malnourished children, in particular, must be given urgent nutritional support at the border and be transferred to medical facilities at once,” says Yapi. 

“Relief items such as mosquito nets, plastic sheets and other essential items should also be provided at the border so nobody who is in need is missed out.”

Although people there receive a one-off cash distribution of US$12 per person, considering the high prices – a normal meal on average is sold for US$2 in Renk – this assistance is hardly enough to afford one meal a day. People stay weeks, and at times months, without further cash assistance and there is no regular food distribution by humanitarian organisations or the authorities in the area. 

Limited food and deplorable living conditions are taking a toll on people’s health. In two mobile clinics run by MSF at Zero and Abukadra, our teams are providing 300 medical consultations a day, and seven out of 10 are malaria patients. 

Most people sleep out in the open or in temporary shelters made of clothing. In this area, patches of stagnant rainwater provide ideal breeding places for mosquitos, while people have no mosquito nets or other means of protection.

Urgent humanitarian response needed 

In Renk civil hospital, where MSF supports the measles isolation ward, 90 per cent of patients are returnees and are unvaccinated. On top of that, some severely sick patients are being transferred without provision of medical care to Malakal, a 48- to 72-hour journey by boat without medical care, water or food.

Deaths have been recorded on these journeys, while our teams are receiving severely sick patients at Bulukat transit centre, resulting in a higher mortality rate in the facilities in Malakal. 

“The community of returnees don’t have sufficient food or drinking water, and they don’t even have shelters – they use pieces of cloth to protect themselves from the sun and rain,” says Abraham Anhieny, an MSF medical doctor in Renk. 

“As we treat malnourished children in the hospital, we see that many mothers are also malnourished,” he says. 

Years of conflict have already caused one of the world’s largest humanitarian crises in South Sudan. The country already suffers from regular disease outbreaks, flooding, displacements and high rates of malnutrition.

The arrival of returnees is yet another burden, and the current response is insufficient to absorb additional needs. The country requires more attention and support to deal with the ongoing humanitarian crisis caused by the conflict in Sudan.